心臓の3Dプリントモデルは手術のプランニングに役立つ（Abstract 20614）

外科医らは複雑な障害を有する患者を心臓の3Dプリントモデルを用いて治療する
Surgeons use 3D printed model of heart to treat patients with complicated disorders
心臓の実験的3次元プリントモデルと標準的な医用画像との組み合わせは、外科医が複雑な先天性心奇形を有する患者を治療するのに有用である可能性がある、との研究結果が2014年American Heart Association年次集会で発表された。ほとんどの心臓外科医は手術のプランニングに際してX線、超音波およびMRIを用いて撮影された2D画像を用いる。しかし、これらの画像は複雑な先天性心奇形を現しきれていない可能性がある。しかし今や、医師は標準的な2D画像をガイドとし、最も複雑な構造異常ですら心臓の詳細な3Dモデルを石膏やセラミックなどの様々な素材で作成し示すことができるようになった。研究者らは安価な石膏複合材料を用いて、複雑な先天性心奇形を有する生後9か月女児、3歳男児および20歳代女性の心臓モデルを作成した。モデルと従来の画像を研究した結果、外科医は重度の心奇形患者3人全ての治療に成功した。このモデルは予後に有益であり得る妥協点を外科医らが見極めるのに役立った。今回のスタディは小規模のもので3Dプリントは今の時点ではまだ未承認の開発中の技術であることを研究者らは警告している。
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An experimental 3-dimensional printed model of the heart, combined with standard medical images, may help surgeons treat patients born with complicated heart disorders, according to research presented at the American Heart Association's Scientific Sessions 2014.

Most cardiac surgeons use 2D images taken by X-ray, ultrasound and MRI for surgical planning. However, these images may not reveal complex congenital heart defects, as opposed to those developing later in life within a structurally normal heart.

But with standard 2D images as a guide, doctors now can build a detailed 3D model of the heart from various materials, such as plaster or ceramic, to reveal even the most complicated structural abnormalities.

"With 3D printing, surgeons can make better decisions before they go into the operating room," said Matthew Bramlet, M.D., study lead author and assistant professor of pediatric cardiology and director of the Congenital Heart Disease MRI Program at the University of Illinois College of Medicine in Peoria. "The more prepared they are, the better decisions they make, and the fewer surprises that they encounter."

"When you're holding the heart model in your hands, it provides a new dimension of understanding that cannot be attained by 2D or even 3D images. What once was used to build trucks, we're using now to build models of hearts."

Researchers used an inexpensive plaster composite material to create heart models of a 9-month-old girl, 3-year-old boy and a woman in her 20s all of whom had complex congenital heart defects. After studying the models and traditional images, surgeons successfully repaired severe heart abnormalities in all three patients.

"You could see that if you make this compromise here, you could fix this problem, and go from a single-ventricle to a two-ventricle repair," Bramlet said. "That is the difference, potentially, between a life expectancy of two to three decades, to four, five or six decades."

Researchers caution that this was a small study and 3D printing is still an emerging technology that is not approved by the Food and Drug Administration.  The University's collaborator, the Jump Trading Simulation and Education Center in Peoria, made the printer available for the study.

Co-authors are Randall Fortuna, M.D., and Welke Karl, M.D. Author disclosures are on the manuscript.

Private donors supported the study.